Individual provider Active NPI

Diksha Venkatesh, PTA

  • Physical Therapy Assistant
  • Burlingame, CA
National Provider Identifier
1013580232
Registry record updated Jul 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
51062 Issued in CA
Practice address
1100 Trousdale Dr
Burlingame, CA 94010-3207
Phone
(650) 692-3758
NPI assigned
Jul 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 51062 CA Primary

Addresses

Primary practice location

1100 Trousdale Dr
Burlingame, CA 94010-3207

Mailing address

10128 E Estates Dr
Cupertino, CA 95014-3304
Phone (408) 637-9649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
51062CAMDPhysical Therapy Assistant

Interoperability endpoints

  • Direct secure messaging: diksha.venkatesh.p1@direct.orthonorcal.nextgenshare.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627084800000",
    "number": "1013580232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10128 E ESTATES DR",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950143304",
            "telephone_number": "408-637-9649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 TROUSDALE DR",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103207",
            "telephone_number": "650-692-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENKATESH",
        "first_name": "DIKSHA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-24",
        "last_updated": "2021-07-24",
        "certification_date": "2021-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "51062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.